Non mental health professionals diagnosing mental health disorders?

It seems nowadays more and more people are going to their pediatrician or general practicing physician for evaluating, diagnosing and prescribing medication for mental health problems. The general public is even being encouraged to do so in fact. (Check out https://www.cdc.gov/ncbddd/autism/screening.html.) Many people trust their physicians and see them as the ultimate authority when it comes to their health. This seems like a good thing, but when can it become a problem? Well, it may only seem to be a problem when you start to think about the details. Do you go see your general practitioner for problems with your teeth? No, you would go to a dentist. Would you go to a podiatrist to help you with surgery for your hand? Of course not, doing so seems silly because all doctors are not equal in their training and expertise. So why would you go to a general practitioner for evaluating and treating your mental health issues? Wouldn’t you want to go to someone who specializes in mental health treatment? Yet, more and more people are seeing their general health practitioners for mental health problems.

In particular, I’d like to discuss the mental health treatment of children. Pediatricians like all doctors go to medical school and will do one rotation of their residency in an inpatient mental health unit. These inpatient units are filled with adults with severe mental health problems and they will likely not see any children. That’s about all the training they get in the mental health field. How does this equate to expertise in mental health? Psychologists have at least six years of training between graduate school and post-graduate training, spending a good amount of that time being supervised by licensed and senior staff while practicing in the field of mental health. Furthermore, psychologists are specifically trained in testing and evaluation of mental health disorders.

Yes, your child’s pediatrician might agree to see your child and evaluate them for ADHD or Autism. They might see you for 15 minutes, ask you a few questions, and maybe have you fill out a rating scale that they can quickly glance over. Your child has met 5 out of 6 criteria based on this information and that’s it! Voila! He or she has been diagnosed with a mental health disorder. Even if the pediatrician administers some psychological testing to your child, this is likely brief and not an adequate evaluation. Moreover, pediatricians have no formal training in psychological testing. Would you want a psychologist to prescribe you psychotropic medication without any training to do so? Likely not, that seems absurd. So why would you want someone with no training in psychological assessment to administer and interpret psychological tests? This is how more and more people are getting misdiagnosed.

Psychologists, on the other hand, will do a structured clinical interview for about an hour and spend several more hours with your child administering a battery of tests to gather objective data about your child’s clinical presentation in order to help them formulate a diagnosis. Having the pediatrician do an “evaluation” (and I use that term loosely because there does not seem to be much of an evaluative process occurring) may be quicker and cheaper. However, you should ask yourself if you want something done quick or if you want to receive a comprehensive and thorough assessment that helps you to identify the right diagnosis? If you hastily receive a diagnosis, you may be treating the wrong disorder. As a result, your child may make little to no progress or even worsen the mental health condition. For children medicating the wrong mental health disorder can have very detrimental effects. Do you want your child hooked on Adderall if he/she does not truly have ADHD? Children’s brains are still developing well into young adulthood and introducing psychotropic medications may have devastating effects on the developing brain. This is something that should take some consideration.

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